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Study: Concussion Rate in High-School Athletes More Than Doubled in 7-Year Period

COLUMBUS, Ohio – Concussion rates in U.S. high-school
athletes more than doubled between 2005 and 2012, according to a new national study
using data on nine team sports.

Overall, the rate increased from .23 to .51 concussions per
1,000 athlete exposures. An athlete exposure is defined as one athlete
participating in one competition or practice.

The increase might appear to sound an alarm about sports
safety, but the researchers suspect the upward trend in reported concussions
reflects increased awareness – especially because the rates went up the most
after the 2008-09 academic year.

Around that time, states began passing legislation promoting
education about concussions and setting “return to play” guidelines for youth
sports. Media coverage about head injuries in professional athletes has also increased
over the last five to 10 years.

Joseph Rosenthal

“It’s scary to consider these numbers because at first
glance it looks like sports are getting more dangerous and athletes are getting
injured more often,” said Joseph Rosenthal, clinical assistant professor of physical medicine and rehabilitation at The Ohio
State University and lead author of the study. “This study is observational so
it doesn’t offer any proof about why the rates are going up. But I think in
reality it’s showing that concussions that were occurring before are now being
diagnosed more consistently – which is important.”

A concussion is an injury to the brain that produces a transient loss of brain function with symptoms of dizziness, lightheadedness, confusion, headache and vision changes. Typically, nothing will be seen on imaging. Recovery usually occurs within a short time, but previous research has suggested that high-school athletes take longer to recover than do older athletes, and that even teenage athletes are at risk for repetitive head trauma.

Rosenthal and colleagues analyzed data from the High School
Reporting Information Online (HS RIO) sports injury surveillance system. The
system contains data from a representative sample of 100 U.S. high schools that
have at least one certified athletic trainer on staff.

Among the injuries tracked by HS RIO, reportable concussions
were those that required medical attention and resulted in a restriction on
athlete participation for one or more days after the day of the injury.
Criteria were expanded in the 2007-08 school year to report concussions regardless
of play restrictions. Concussions were diagnosed by the athletic trainers using
their expertise, as well as any physician consultation.

The researchers calculated the rates by dividing the
reported number of concussions by the total number of athlete exposures for
each sport. In the time frame studied, HS RIO contained almost 11.3 million
athlete exposures for the nine team sports.

In addition to the overall doubling of concussion rates, the
rates of these head injuries increased significantly in five sports: football,
boys basketball, boys wrestling, boys baseball and girls softball. The other
four sports showed upward trends in concussion rates, but based on statistical
analysis, those increases could have occurred by chance. Football had the highest
concussion rate among these nine sports.

Rosenthal, a physician who treats non-athletes with
concussions and other brain injuries at Ohio State’s Wexner
Medical Center, noted that concussions affect much more than just the
ability to play sports.

“A lot of injured athletes don’t want to come out of games
or stop practicing because they don’t want to lose their position. But they can
have symptoms that can last for an extended time period that can affect
day-to-day life, school and personal relationships – they can experience
irritability, pain, difficulty concentrating and sleep problems,” he said. “Furthermore,
if they continue to play while symptomatic, they are at risk for a second
impact that can lead to severe disability and death. If you have symptoms,
you’ve got to rest your brain and prevent further injury in order to recover.”

Tracking these injury rates over time will enable
clinicians, coaches, parents and athletes themselves to understand what risk
factors influence changes in concussion rates and explore new ways to protect
young athletes, he said. This initial study, Rosenthal said, suggests that “people
are starting to recognize the seriousness of concussions and how important it
is to treat them appropriately.

“Our theory is that more people are looking for concussions,
and athletes, parents and coaches are being educated on the symptoms and
importance of removal from participation, as well as treatment. There is a
greater emphasis on monitoring for injury.”